The downside of your check-up

FOR years I’ve avoided check-ups. Even now at the age of 42 I’m scared of admitting how much I drink, how little I exercise and my excessive love of cheese. So being forced recently to have a Bupa health check before starting a new job made me nervous in the extreme.

After a couple of hours I’d been thoroughly MOT-ed by an ECG heart check, a blood pressure monitor and a breast exam. We discussed my insomnia and investigated both my hearing and cholesterol levels.

My risk of diabetes was rock bottom and my liver seemed to be holding up despite everything I’ve thrown at it over the years. I relaxed, safe in the knowledge that everything’s ticking along nicely.

However the findings of a study in Scandinavia suggest when it comes to detecting heart disease or cancer, check-ups can lull patients into a false sense of security.

The Danish researchers studied 14 long-term medical trials over nine years. Some of the 180,000 participants were offered regular health checks while others weren’t. Most trials showed no difference in ensuing death rates.

Heart disease and cancer caused the same number of deaths in those who had check-ups as in those who hadn’t. Even when conditions were swiftly diagnosed and drugs prescribed there was no significant difference in longevity. “There is ongoing debate about the value of general health check-ups in otherwise symptom-free people,” says Dr Gill Jenkins of the Simplyhealth Advisory Research Panel.

Don’t let your annual physical lull you into a false sense of security

“There is plenty of evidence that specific checks such as cervical screening are very valuable in picking up changes early on in the disease process.

“Blood pressure screening after a certain age has evidence to support it too but for many conditions general health checks in a symptomless person have little or no value.”

Clearly screening for certain conditions is vital. After all if my check-up had uncovered raised blood pressure, a worrying lump or a heart murmur I would have been sent for further investigation. Yet the research suggests doctors should assess a patient’s personal health risks rather than simply running through a basic battery of tests.

We should pay more attention to any changes in ourselves too.

“Better health education on the importance of reporting changes in weight, skin lesions or energy levels rather than just symptoms may be more effective than routine health checks,” agrees Dr Jenkins. “Check-ups should be an opportunity to make patients aware of what to look for.

“For instance if a patient has a family history of high cholesterol, doctors can advise on diet, exercise and prevention.”

The low rate of diagnosis from check-ups is why the NHS doesn’t offer routine health checks until the statistical risk of disease has increased with age.

“After 45 we suggest people have their blood pressure checked even if they feel well,” says Dr Jenkins. “People ask for routine check-ups and they may be given a quick check of the important risk areas such as blood pressure, chest sounds, abdomen.

“Yet the enormous costs involved mean it makes sense to focus on treatments and diagnostics that improve the quality or length of life.”

It seems the key to a successful check-up is to know your risk factors. “Healthcare professionals can only advise and present the information,” says Dr Jenkins. “Some patients will use a clear health check to justify ongoing behaviour such as smoking and drinking no matter how carefully counselled they are.”

Maybe I do need to rethink that wine intake before my next appointment after all.

WHEN SHOULD YOU HAVE AN MOT?

Any of the following conditions should mean a trip to your GP

Energy levels: If your energy has dropped for no apparent reason and you haven’t been under particular stress.

Skin problems: Moles and lesions that are bleeding, cracked or have changed shape.

Weight changes: If your diet hasn’t altered but you are losing or gaining weight. Unexplained bleeding:

Between periods, after sex or on the loo, bleeding for no apparent reason can be a sign that all is not well.

Persistent cough: If it has lasted longer than a fortnight it might be more than a tickle.